Cataract Surgery
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Cataract Surgery
What is CATARACT?
The human crystalline lens, which is clear and transparent is part of the focusing mechanism of the eye. With age, the lens becomes cloudy and opaque, thereby hampering normal vision. Any opacity in the crystalline lens, which leads to decreased vision, is cataract. The early cataractous lens bends light irregularly, so the images formed are blurred and unclear. When opaque, the cataract may cut off light nearly in total, causing blindness (reversible).
What causes Cataract?
Ageing is the most common cause. With age, proteins of the eye lens get altered
and opacified leading to cataract. Other causes include congenital and
developmental anomalies, trauma, inflammation of the eye, metabolic diseases like
Diabetes, Hypothyroidism etc.,
What are the common symptoms of Cataract?
Cataract makes simple tasks difficult and in some cases impossible to perform.
- Clouded, blurred, or dim vision.
- Difficulty seeing at night.
- Increased sensitivity to light and glare.
- Need for brighter lighting during reading and other activities.
- Perception of “halos” around lights.
- Frequent changes in eye glass or contact lens prescriptions.
- Fading or yellowing of colors.
- Double vision in one eye.
These symptoms may not be noticeable at first, as cataracts develop slowly. However, as the cataract grows, it can lead to more noticeable vision changes
What are the treatment options for Cataract?
The treatment options for cataracts primarily involve surgical intervention, as there are no proven non-surgical methods to reverse the clouding of the lens. Here’s an overview of the treatment options:
- Observation: In the early stages, cataracts may not significantly affect vision. Patients might just need a new prescription for glasses or stronger lighting. Regular monitoring is advised to assess how the cataract progresses.
- Cataract Surgery: This is the primary treatment for cataracts when they start to impact daily activities. There are two main types of cataract surgery:
- Phacoemulsification (Phaco): The most common method, it involves a small incision through which a tiny probe is inserted. This probe emits ultrasound waves to break up the cloudy lens, which is then suctioned out. A clear artificial lens, called an intraocular lens (IOL), is then inserted.
- Extracapsular Cataract Extraction (ECCE): This method is used for advanced or very dense cataracts. It involves a larger incision to remove the cloudy lens in one piece, followed by the insertion of an IOL.
- Intraocular Lenses (IOLs): Different types of IOLs can be used depending on the patient’s needs:
- Fixed-focus Monofocal: These lenses provide clear vision at one distance only (near, intermediate, or far).
- Multifocal or Accommodative IOLs: These lenses can reduce the need for glasses by providing clear vision at multiple distances.
- Toric IOLs: These are designed to correct astigmatism as well as cataracts.
- Laser-Assisted Cataract Surgery: This newer technique uses a laser to make incisions and soften the cataract for removal. It’s known for its precision and may reduce the risk of complications.
- Post-Surgical Care: After cataract surgery, patients are usually prescribed medicated eye drops to prevent infection and reduce inflammation. Follow-up appointments are necessary to monitor the healing process.
Conventional Cataract surgery or Extra Capsular Cataract Extraction (SICS/ECCE)
Injections are given near the eye
• Requires an incision of 7-8 mm
• The cloudy eye lens is removed in one piece
• A hard plastic lens is implanted
• Multiple Stitches are required in ECCE
• Final glass prescription could take even upto 10 weeks
This happens on account of :
• Cloudy or Blurred Vision
• Changes in one’s perception of colours
• Sensitivity to bright lamps or sunlight
• Poor night vision
• Difficulty in driving especially at night
• Frequent changes in eye glass prescription
• Sensitivity to bright lamps or sunlight
Conventional Surgery Wound Microincision Cataract Surgery (PHACOEMULSIFICATION)
Requires a very small incision of 1.5 – 2.8mm
• Cataract Extraction with Phacoemulsification is followed by
• foldable lens implantation :
• Walk-in Walk-out procedure
• Stitchless, bloodless, painless surgery
• Chances of infection are very low
• Minimum post surgery precautions
• Quicker healing and recovery
• Phacoemulsification Microincision
Cataract should be removed as soon as it begins to affect daily activities. With any
of the above mentioned symptoms setting in, it is the right time to go for Cataract
removal. DO NOT WAIT FOR THE CATARACT TO GET MATURE as unnecessary
delay can lead to avoidable complications and more difficult surgery. Cataract
surgery can be undertaken successfully in any season. Summer or rainy season
have absolutely no effect on the outcome of the cataract surgery.
What is the recommended treatment for cataract ?
With phacoemulsification and implantation of foldable Intra Ocular Lens (IOL),
treatment of cataract has become very simple and sophisticated. The procedure is
safe, accurate and leads to rapid recovery. Thus phacoemulsification with foldable
lens implant is the most recommended treatment for cataract.
What is phacoemulsification with foldable IOL ?
In phacoemulsification, ultrasound power is used to break the hard cataract into
minute pieces, which are then sucked out through a small 1.5-2.8mm incision. A
foldable lens (IOL) of the required power is then implanted. The soft construction
allows the lens implant to be folded for insertion through a 1.5 to 2.8mm micro
incision. Once in place, the lens unfolds to its regular size of 6 mm.
PHACOEMULSIFICATION FOR CATARACT
Phaco Incision
IOL Insertion
Pha co In Progress
Post IOL
What are the advantages of phacoemulsification with fold-able IOL over conventional cataract surgery ?
• It allows for a injection less, stitch less, painless, no bandage surgery
• Drops of local an-aesthetic agent are used instead of an injection in the eye,
thus leading to a walk-in
• walk out procedure
• Early visual rehabilitation for the patient
• Minimum curvatural changes occur in the eye following surgery
• Post surgery, the wound is very secure
• Final glasses can be prescribed within two weeks
How soon after phaco surgery, will I be able to see ?
In some cases, the patient is able to see almost immediately following the surgery,
although most patients experience clear vision after one or two days
Will I need glasses after phaco surgery?
You may need to wear glasses only to fine -tune your vision. These spectacles
have normal lenses unlike thick lenses used in the past. If unifocal IOL is used,
near vision glasses are almost always required.
Will activities have to be restricted after phaco surgery ?
Normal activities including walking, reading, writing, watching television etc. may be resumed soon after the surgery. However, during the first week after the surgery, it is better to avoid strenuous activities & avoid exposing the eye to water or dust.
Is there any diet restriction after phaco surgery?
There are absolutely no diet restrictions after phaco and you can continue with
your normal diet. However, diet regulation advised for other diseases like Diabetes,
High blood pressure, etc must continue.
Can I have phaco surgery on one eye even if the other eye had been operated upon by the conventional surgery ?
Yes, you may have micro incision Phaco surgery on your “Second Eye” provided
there is no specific contraindication for Phaco.
How long will the procedure take ?
Trifocal IOL :
The latest multifocal IOLs are designed to provide good distance vision, intermediate and near vision. They reduce the patient’s dependence on glasses for routine activities. Unlike conventional IOL it has multiple zones of different focal lengths that bring everything from near to far into clear focus. These lenses can be used only for suitable patients.
